SUPERHERO POSE Flashcards
Rate pressure product
HR x SBP
Indication of myocardial oxygen demand
Squat test
For ruling in or out a hip fracture
Pt with hip fx will report inc pain with WB
Psoas abscess symptoms
Night sweats
Low grade fever
Patrick test
Rule in or out hip joint dysfunction
McBurney test
Appendicitis
RLQ, umbilical region pain
N/V, low grade fever
Iliopsoas muscle test
Screening for psoas abscess
Abnormal lymph node
Firm, mobile, tender or nontender
Stenosis on the R side - what cervical motion gives most relief?
Flexion, L SB, L rot
Listers tubercle 3.37
EPL
Exopthalamus
GRAVES! Hyperthyroidism
Grip for grabbing a suitcase
POWER GRIP! Slight ext and ulnar deviation
Exercise with dyslipidemia
ASCM says mod intensity of 40-80% of HR reserve 5 or more times per week
Spastic bowel occurs with injury where
Above S2
Palpate the supraspinatus - shld in what position
Extension and IR
Legg Calve Perthes - affects what
Common gait deviation
hip (4.32)
Trendelenburg
Second degree type 1
Progressively lengthening PR
Abdominal paradoxical breathing
Upward and outward motion of the upper chest
Inward motion of the abdomen
Manual lymphatic drainage - order (4.38)
Decongest involved trunk quadrant before decongesting the involved limb
Impaired proprioception may be the result of malavsorption of which nutrient
Vit B12!
Dec B12 can lead to pernicious anemia which gradually affects sensory and motor nerves
Impaired levels of K would impact
mm contraction
Heart, intestines, resp tract
Iron deficiency can occur secondary to ___ and produce symptoms of ___
Can occur secondary to blood loss, malabsorption, pregnancy
Symptoms of irritability, lack of ex tolerance, HA
Beta blockers
Dec HR
Dec BP
Dec oxygen demand
Thiazide =
Diuretic
Adverse effect to Thiazide
Diuretic
Lead to enhanced secretion of Na and K in urine which leads to hyponatremia and hypokalemia
Clammy skin, hypotension = signs of hyponatremia
Dizziness and hyperventilation = signs of hypokalemia
Signs of hyponatremia
Clammy skin
Hypotension
Signs of hypokalemia
Dizziness
Hypoerventilation
Signs of tethered cord
Rapidly progressive scoliosis
Hypertonicity in LEs
Changes in gait
Changes in urologic function
Normal atrial pressure
0-8 mmHg
L innominate posterior rotation
L sulcus becomes deeper
L ASIS is more superior
Rubor of dependency test
For arterial insufficiency
Lay supine, elevate leg - positive if rapid loss of normal pink color of skin and takes a longer time (more than 30 sec) for color to return when back in starting position
Compression pressure for someone with venous wound
SHORT stretch (high working, low resting) 40 mm Hg
Measuring wheel chair back height
Should fall below inferior angle of scapula
Measure from seat of chair to floor of axilla with pt shld flexed to 90 and then subtract 4 in from there
Hip position to prevent contracture after burn to anterior hip
Hip extension and ABDuction
Hip spica and hip abduction splints are commonly used
Intrinsic factors that affect wound healing
Hydration
Nutrition
Body composition
Extrinsic factor affecting wound healing
Maceration
Braden scale
Pressure ulcer predictor - perception, moisture, activity, mobility, nutrition, friction, shear
All scored 1 - 4 except friction and shear only scored 1 -3
Max score is 23
18 or less = need pressure ulcer prevention program
Bacterial agent most responsible for skin infection
Staph auerus
BMI Normal
18.5 - 24.9
Percussion test
Venous insufficiency
Percuss distal segment of saphenous vein while palpating proximal segment
If sense blood movement proximally, the valves are not functioning properly
rule of 9s not used for
superficial burns
rule of 9s - anterior right leg and foot
9%
Rule of 9s - posterior of B legs and feet
18%
Rule of 9s - anterior trunk
18%
Rule of 9s - posterior arm, forearm, hand
4.5%
Rule of 9s - what age does a child fit the adult rules?
age 9
Rule of 9s - child under 1 yr - what happens
9% is taken from LEs and added to head and neck
Each yr of life 1% is distributed back to LEs until age 9 - when normal values apply
Rule of 9s for child vs. adult
Head and neck is 18% and LEs are each 14%
Adult - Trunk total is 36%, 18% for each LE, 9% for each UE, 9% for head and neck, and 1% genitals
Wagner scale
Ulcer grade classification (diabetic) - uses wound depth and presence of infection
0 = pre ulcerative 1 = superficial w/o subQ 2 = penetrates subQ, exposed tendon, bone, lig 3 = osteitis, osteomyelitis 4 = gangrene of digit 5 = gangrene of foot, disart
Proliferative phase of healing =
Development of new tissue
2-3 days after injury, fibroblasts enter and develop new tissue which marks onset of proliferative phase
Inflammatory phase of healing =
bleeding is reduced as blood vessels constrict
Infiltration of neutrophils too
drying out or dehydration of a wound =
Dessication
peeling or shedding of epidermis
desquamation
abrasion =
rubbing or scraping of epidermal layer of skin
often due to friction btw skin and transfer surface
excoriation
linear scratch on surface of skin
induration =
hardening of a normally soft tissue or organ
Usually due to inflammation, infiltration of neoplasm, or accumulation of blood
Contraindication to whirlpool
venous insufficiency
medial malleolus wound
Venous!
technique to temporarily relieve night pain in someone with arterial insufficiency
Leg in dependent position to temporarily improve circulation
spleen - which quadrant
LUQ
endocrine gland - sleep/wake cycle
Pineal!
which gland produces calcitonin
post pituitary gland
Calcitonin lowers blood Ca levels
in response to elevated blood glucose, the
pancreas secretes insulin
Post pit gland secretes
Oxytocin
ADH
gout - need to avoid
Food high in purine
alcohol
make sure to drink plenty of water
Addisons disease
hypofunction of adrenal cortex
Dec cortisol and aldosterone
Hypotension, weakness, anorexia, altered pigmentation
Cushings
Excessive cortisol
hyperfunction of adrenal gland
Serious side effect of hyperparathyroidism
Increased parathyroid hormone causes Ca to leave the bone resulting in OP
Hypoglycemic state s.s
Slurred speech, lack of coordination, staggering gait
Inc HR, pale, moist skin, anxiety, tremors
He iS TIRED
HA, Sweating, Tachycardic, Irritable, Restless, Excessive hunger, Dizzy
PKU should avoid
foods with phenylalanine
Meats, dairy, eggs, nuts, legumes, seeds, breads, and aspartame
Osteomalacia
softening of the bones
often caused by vit D deficiency
(rickets in kids - bowing of the legs)
Paget’s disease
Osteitis deformans
Thickened, spongy, abnormal bone formation
Bowing of long bones, inc skull size, bone deformities, fx (usually of vertebrae)
Metabolic syndrome - diagnosis needs
at least 3 of the 5 Elevated blood glucose Elevated BP Elevated triglycerides Dec HDL Abdominal obesity (based on waist circumference)
Common cause of metabolic alkalosis
HCO3 high
Excess bicarb or acid is lost
Prolonged vomiting is common cause!
Common cause of metabolic acidosis
Diarrhea and renal failure
Common cause of resp alkalosis
hyperventilation
Dowager’s hump
kyphotic curvature of thoracic spine secondary to OP that occurs in postmenopausal women
Class 1 drug
No accepted medical use in US
Hgh potential for abuse
Herroisn and LSD are exampls
Biophosphonates are used for
OP
Allupurinol used to treat
gout
Airborne precautions
private room with negative air pressure 6-12 air changes within room per hour Room door closed Resp protection worn when enter room Limit pt transportation outside the room
Examples of need for airborne precautions
TB
Varicella
Measles
Droplet precautions
Private room Maintain at least 3 ft btw pt and any contact Room door can be open Wear mask Limit transport out of room
Droplet precuation examples
Influenza
Neisseria meningitis
Pneumonia
Contact precautions
Private room
Gown and gloves when entering room
Take gloves off prior to leaving room and perform hand washing
Limit pt leaving room
Nosocomial infection =
Acquired during hospital stay
Min for hand washing
30 sec
Every ramp should have ____ of horizontal run for every ___ of vertical rise
Should have 12 inches of horizontal run for each inch of vertical rise
equivalent to a 8.3% grade
A ramp should be a min of ___ inches wide
36 inches wide!
Ramp needs a rail if
rise is greater than 6 in and run is longer than 72 inches
If a ramp changes directions, the landing area should be at least
5 feet by 5 feet
60 in x 60 in
Doorway width - accessibility
min 32 in
Carpet - accessibiity - requires ____ pile or less
1/2 inch pile or less
Hallway has to be what width
36 in in width
Wheelchair turning radius needed - accessibilityy
60 in wide
78 in long
Bathroom - grab bars - accessibility -
1.25 to 1.5 inches in diameter
1.5 in space btw grab bar and wall
placed 33-36 in above the floor level
Crutches - fitting
Base of crutch should be placed 6 in anterior and 2 in lateral
Crutch height should be no greater than 3 finger widths (2 in) from axilla
Allow for 20-25 deg of elbow flex
Medial sole flare is used to resist
Eversion
What reduces joint compression when walking in waist high water
Buoyancy
Effects of hydrostatic pressure
Inc venous return
Dec HR for a given workload
Dec edema
Dec WB
Positive sharp waves with EMG can be indicative of
Muscular dystrophy
Abnormality with EMG associated with LMN
Fibrillations
Electrode size and impedance
Large electrode size - dec impedance
Small electrode size - inc impedance
Large electrode size - current density and flow
Large electrode size = inc current density
Dec current flow
The farther apart the electrodes are placed the ___ the current travels
Deeper!
Intermittent compression for LE vs UE
LE 80-90
UE 40-60
In general, to avoid cardiac complication, the pressure with intermittent comp device should always be lwoer than
systolic pressure!
